Individual
AYELET DISSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
622 W 168TH ST STE VC260, NEW YORK, NY 10032-3720
(212) 305-6059
Mailing address
622 W 168TH ST STE VC260, NEW YORK, NY 10032-3720
(212) 305-6059
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
031099
NY
363A00000X
Physician Assistant
4060
CT
Other
Enumeration date
04/17/2018
Last updated
01/26/2024
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